Recovering at Home After Hip Fracture
Each year, more than 350,000 Americans experience a hip fracture. Hip fracture is a serious injury that can lead to loss of mobility and independence. Ninety percent of these patients are over age 65, and 20 percent of them will spend the rest of their days in a nursing home. Even more sobering, the American Medical Association says that up to a third of these seniors will die within a year of the injury.
Yet according to the American Academy of Orthopaedic Surgeons, most people who fracture a hip will eventually regain most or all of their former mobility and independence. Successful recovery depends on the type and severity of the fracture, the patient’s overall health—and especially, on how well the patient complies with the prescribed recovery regimen.
Treatment for hip fracture almost always begins with surgery, either a partial or total hip replacement, or repair using a metal plate and/or screws. The surgery is followed by lengthy rehabilitation. In days past, extended post-surgical bed rest was recommended. But doctors now know that beginning active rehabilitation right away yields the best outcome. It is vital to follow the healthcare provider’s instructions, because certain movements and activities can cause dislocation of the prosthetic hip or repair before healing is complete.
After surgery, patients remain in the hospital for about a week. Many then move to a nursing home or rehabilitation facility as they regain their ability to walk. Others are discharged directly home, continuing rehabilitation through supervised outpatient treatment. In a recent study on hip fracture recovery, experts from the Gerontological Society of America said, "Programs aimed at helping older patients recuperate successfully at home instead of in an institutional setting could greatly improve their health outcomes and reduce healthcare costs."
Whether patients are discharged directly home from the hospital or from an intermediate care setting, they most likely will require help with their ongoing rehabilitation and the activities of daily living. Many services can be provided once the patient is discharged home:
Physical therapy, provided either at home or on an outpatient basis, helps the patient learn to walk safely, regain muscle strength and control pain.
Occupational therapists help patients learn to perform personal care tasks safely. They also instruct patients in the use of assistive devices such as a walker, cane, long-handled kitchen implements and dressing aids.
Home modifications add safety and convenience for the recovering patient. These might include grab bars and an elevated toilet seat in the bathroom; stair railings; improved lighting; rearranging the kitchen; and perhaps modifying the home for single-story living.
Skilled nursing care services, including wound care and medication administration, can be provided in the home.
In-home companion care, less costly than skilled nursing, can be an effective choice to support successful recovery. Trained in-home caregivers provide:
- Support for the patient’s home rehabilitation. The patient will have a set of exercises and other rehabilitation tasks to perform at home. Following this prescribed program makes all the difference when it comes to regaining mobility and independence! Yet patients may be fearful of falling or experiencing discomfort. In-home caregivers provide the supervision and encouragement that inspires confidence.
- Personal care assistance. In-home caregivers help patients with dressing, grooming, going to the bathroom, transferring from chair to bed or wheelchair, and other tasks that can be challenging during the recovery period.
- Housekeeping and home safety assistance. Many household chores we take for granted may be off-limits or difficult during the recovery period. Lifting, bending and leaning may be forbidden as the prosthesis or repair heals. An in-home caregiver can keep the house clean, and be alert for clutter and other hazards that might cause a fall. (More than 90 percent of hip fractures result from a fall—and hip fracture itself raises the risk of falling.)
- Transportation. Driving is also usually off-limits for several weeks or months after hip fracture surgery, but most patients will have regular outpatient rehabilitation appointments. The in-home caregiver can transport the patient to these appointments, to the pharmacy to pick up prescriptions, and on pleasant outings of the patient’s choice. Getting out and about helps ward off depression and isolation, both of which impede successful recovery.
- Grocery shopping and meal preparation. The patient’s healthcare provider will probably prescribe a diet that is rich in protein, calcium and vitamin D. The in-home caregiver can serve nourishing, appetite-tempting meals that meet the client’s individual nutritional requirements.
In-home care is available for several hours a week, or 24/7. Depending on the patient’s condition and speed of recovery, in-home care may only be necessary for a short time. In other cases, especially when seniors are dealing with multiple health challenges, in-home care can be a long-term care solution to allow the person to remain in their own home as long as possible.
The American Academy of Orthopaedic Surgeons offers information about hip fracture types, causes, treatment and recovery.
Visit the Right at Home website to read about the RightTransitions Initiative, a program to support patients at home after hospitalization.
For information on topics related to home care and healthcare, visit our Home Care and Healthcare Advocacy group on LinkedIn.
Right at Home, Inc. is a national organization dedicated to improving the quality of life for those we serve. We fulfill that mission through a dedicated network of locally owned, franchised providers of in-home care services.